USPSTF takes a look at vitamin supplements

What's New From the USPSTF Routine vitamin supplements to Prevent Cancer and Cardiovascular Disease

This series of fact sheets is based on the work of the U.S. Preventive Services Task Force (USPSTF). The USPSTF systematically reviews the evidence of effectiveness of a wide range of clinical preventive services—including screening, counseling, and chemoprevention (the use of medication to prevent diseases)—to develop recommendations for preventive care in the primary care setting.

This fact sheet presents highlights of USPSTF recommendations on this topic and should not be used to make treatment or policy decisions applies only to the use of

vitamin supplements by healthy adults to prevent cancer and cardiovascular disease. The Task Force did not review evidence for vitamin supplementation in patients with known or potential nutritional deficiencies—including pregnant and lactating women, children, the elderly, and people with chronic disease—or special populations of patients, such as those taking medicines that require augmenting.

What Does the Evidence Indicate? There is inadequate evidence that vitamins, when taken to augment a healthy diet, can prevent heart disease or cancer. Studies reviewed by the Task Force were not of long enough duration for the Task Force to draw clear conclusions. The longest study reviewed by the USPSTF lasted 5-6 years, which may not have been long enough to rule out a possible benefit. The results from high-quality studies are mixed. A few observational studies suggest a possible benefit of some on both heart disease and cancer, but the results from other studies show no benefit. Even for the observational studies that show some benefit, the Task Force could not be certain whether the benefit could be attributed to other factors.

There is inadequate evidence that suggests prevention of heart disease or cancer.

Should People Take Vitamin Supplements? With the exception of products that can cause harm, there is little reason to discourage people who wish to take them from doing so. Taking extra minerals etc., does not replace the need to eat a healthy diet, although this adjunct may be appropriate for people whose diet does not provide the recommended daily allowance of specific vitamins. Recommended daily allowance information is available from the Institute of Medicine's Dietary Reference Intake (DRI).

All patients should receive information about the benefits of a diet rich in fruit, vegetables, and legumes, as well as information about other foods and nutrients that should be emphasized or avoided.

Taking vitamins does not replace the need to eat a healthy diet.What Are the Potential Harms? Beta-carotene add-ons were associated with an increased risk for lung cancer among smokers, especially heavy smokers, in 2 randomized clinical trials (RCTs); the effects of beta-carotene additives among nonsmokers are unknown.

Moderate doses of vitamin A may reduce bone mineral density. High doses of vitamin A may be toxic to the liver and put pregnant women at risk for delivering babies with birth defects.

People who choose to take vitamins should be encouraged to adhere to the dosages recommended in the DRI of the Institute of Medicine, since the potential harms of higher dosages outweigh the potential benefits.More Information

For more information contact the following organizations: healthfinder® water soluble